Recently, topic has sparked an ongoing controversy, which inevitably leads to a moot question “is it advantageous or not?”. Whereas it is a widely held view that x is highly beneficial, I will discuss controversial aspects of that throughout this essay.
From the psychological standpoint, x is bound up inextricably with x, which indicates they lead to y. As a well-known example, a longitudinal study conducted by eminent scientists in 2014 demonstrates the relationship between y and y. Consequently, my empirical evidence presented thus far supports the contention that the likelihood of y is correlated positively with x.
Within the realm of sociology, without the slightest doubt, x attribute to x, in that it would come down to y. A salient example of such attribution is y, which is a cause for concern since it was mistaken to take y for granted. Had there been a paradigm shift earlier, scholars might have had the opportunity to pinpoint social problems. Hence, it is reasonable to infer the pivotal role of topic.
To conclude, as for myself, as the saying goes “all’s well that ends well,” after analyzing what elaborated above, I firmly believe that the advantages of topic are of more significance.
The video explains the causes of World War I and the short-term cause of the war, which was the assassination of Archduke Franz Ferdinand. It also discusses how the war led to discontent at home and the Easter Rebellion in 1916. The British were eventually able to subdue the rebels, but the war illustrates the power of the stalemates and casualties abroad.
This video explains the causes of World War I, which were primarily militarism and imperialism. The video also discusses the short-term cause of the war, which was the assassination of Archduke Franz Ferdinand.
In World War I, airplanes became a formidable weapon, resulting in high casualties. The war was called a total war because all state resources were used to fight. This led to discontent at home and the Easter Rebellion in 1916. The British were eventually able to subdue the rebels, but it illustrates the power of the stalemates and casualties abroad. World War I significantly altered the global balance of power. The United States emerged as a major global power and old European empires were disbanded. Germany was severely punished in the Treaty of Versailles, losing its position as a major European power. This punishment led to World War II.
In 2023, table grapes were the third-most-purchased fruit in the United States, surpassed in popularity by only bananas and apples, according to a survey by the produce-industry newspaper The Packer. Is this in part because they ask so little of us? Who bothers to peel a grape? Plop a cluster on a plate and serve.
But there are rewards for treating grapes as more, as an ingredient, something with multiple shades of flavor and the capacity to transform. Roast them in the oven until the skins pucker and split and the flesh grows slouchy, verging on collapse. What was once a high, reedy pitch of sweetness takes on body and depth. Taste and texture are almost one: jammy and louche, with a tinge of dark wine.
Developing a game has a couple steps. Firstly, brainstorming and researching what you would want a game to be like. Comparatively, when you’re done researching you can begin developing the first draft of the game. Moreover, you will have to double check to see if the game makes sense to you. Likewise, you will have to test the game for any bugs. In conclusion, you will advertise it on social media platforms and then release it.
First,we started researching and brainstorming what game we wanted to create. Comparatively, we began developing with our research. Moreover, as we developed we made sure the game made sense and was playable.Likewise, we made sure there weren't any bugs, and that it wouldn't crash.In conclusion, we advertised the game to get people to join and play. Video games are very enjoyable and bring happiness to people.
Optimal Hopelessness
As a drug of choice, denial is useless. No matter how much we deny what is happening, it still happens. Why? Denial is a thought. Can a thought know reality? Can a thought replace what is here? Can a thought make a fact disappear? Sometimes it seems worth a try, especially when, for example, a husband uses his wife.
A woman was angry because her husband no longer paid for house expenses nor wore his wedding ring. She told me she wanted to mention the money to him for the thousandth time but felt hopeless.
“That makes sense. Would you agree that bringing it up again is hopeless?”
“I can’t believe he doesn’t pay his share of the expenses.”
“That’s okay. You don’t have to believe it for it to exist.”
“I don’t get it.”
“You don’t get reality.”
“I keep hoping he will change.”
“You keep hoping the reality of your husband will change.”
“Shouldn’t he want to pay for his children?”
“Shouldn’t he be the same as you want him to be?”
“It would be nice.”
“Yes, it would. We can wish this were true, but it’s not. We can rage at what no longer exists, or we can take another path. Giving up on this road doesn’t mean you give up on yourself or on life. It means taking another path.”
“I get it. I have to face reality.”
To hope that the real will become unreal is not hope but denial. Life bumps into our illusion and reveals that resisting facts is futile. This woman was not hopeless, nor was her husband. Her delusion was. We don’t need to give up on a person or on ourselves but on a hopeless fantasy. Then our suffering stops. She needed to stop waiting for her husband to turn into her fantasy in order to release herself from her suffering.
We rage, hoping life will turn into our wish. The result is a sore throat. Life still exists as it is. Once we accept that our wish is a fantasy, we rest in optimal hopelessness: we recognize that it is hopeless to wait for what is true to become not true.
When we let go of the imaginary offerings of our illusions, we become open to the real offerings of life. As the philosopher Ernst Bloch points out, genuine hope occurs when we reach out to find what has been stretching toward us.7 When we reach out to the real, we feel hope in the possible. At that moment we seem to expand. Hope does not expand us, however. Hope reveals the expanse that lives outside our fantasies, the inner expanse that we are but had forgotten.
The therapist helps us see the lies that blind us into hopelessness so we can see what is real, pursue it, and regain our hope. The moment we leave the path of denial, the path to the possible opens. We must give up hope in hopeless fantasies to regain realistic hope in what is real.
I Can’t Stand It!
Rather than embrace what is and let our illusions dissolve, we ask life to wait until we can “handle” it. For instance, we claim that “this is too much,” we are “not ready,” or “what happened should not have happened.”
An outraged businessman said, “I can’t stand it! She knew what she was doing, and it was wrong!” He had ignored his wife and her complaints. Then she had an affair.
We say we can’t stand it, but we do. “I can’t stand it,” means, “I don’t want to.” Who does?
Life seems to be against us. Yet since we are life, we cannot separate ourselves from it. Life includes us. What is “against life” is our belief that life should be the same as our fantasy.
Our beliefs always lose because life doesn’t obey our orders. It may appear that it is too much for us, but it’s not. Life is too much for our beliefs, shattering them every day—if we’re lucky. As they shatter, we mistakenly think we are falling apart, but our fantasies, masquerading as our essence, are dissolving into nothingness.
And who better to shatter our fantasies than a child not living up to our hopes. A mother had failed to protect her son adequately from an abusive father. Later in life, the son blackmailed the mother into supporting him financially, claiming that his problems were her fault. He kept browbeating her until she broke down and coughed up more cash. As I showed her how he blackmailed her, the ways she tried to purchase his forgiveness, and how her bid to “buy peace” bought more war, she said, “This is killing me.”
“No. This is killing your illusions.”
She nodded, pursed her lips, and burst into tears. “But I don’t want the relationship to be harmed.”
“How can you harm something that no longer exists?”
She related to the imaginary son she wanted, not the real son she had. And she wished he would relate to her, not to the projection he had placed upon her. He viewed her as an evil person who deserved to suffer for eternity and should pay reparations until death. She feared the good relationship she desired would be harmed, but it didn’t exist and hadn’t existed for decades. He saw an image, not her. She saw an image, not him, for she longed for a loving son, the one who had disappeared.
As we let go of our illusions, we can live the truth we feared. When this woman gave up waiting for the son she wanted, she stopped trying to buy his love, and loved the real son she had instead. The blackmail came to an end.
Before burying our dead hopes, we may stage another protest: “Why does this happen?” Translation: “Why does reality happen to me?” Life whispers, “Why not? I happen to everyone else. It’s nothing personal.”
Take me, for example. I used to say, “I never get sick.” Then I was diagnosed with cancer. My fantasy, previously viewed as a fact, fell into the psychic trash bin. I didn’t fall apart; my thought did. Tumors didn’t need to fit my mind to grow in my body.
“I don’t understand why this is happening,” we say. That’s okay. Whatever is happening does not need our understanding. It exists whether we understand it or not. Not registering the facts, we try to bargain with the universe, hoping life will say, “You don’t get it? Fine. I won’t show up until you do.”
One way we fight facts is by refusing to understand our spouses and asking them to explain themselves until we do. An irritated wife asked her husband, “Why do you spend so much time playing online chess?”
“I enjoy it.”
“It doesn’t make sense. It’s a waste of time. It’s not productive.”
“Look. I have done my chores. I have free time. I enjoy this. How do I get you off my back?”
“You have to convince me why it’s a good idea.”
It was not his job to convince her why he liked what she didn’t like. She tried to bully her husband by not understanding him, hoping he would say, “You don’t understand me? Okay. I’ll stop being me until you understand why I have a right not to be you.”
She gave him the message “How can I manipulate you to want what I want? If I can dominate you, my problems are over.” This strategy always fails because differences never end. We want the whole person without the parts we don’t like, but the parts make the whole.
Our spouses will never shrink to match our understanding nor stretch to fit our fantasies. Why? Reality, being everything, includes our fantasies, whereas fantasies are designed to exclude what is real. We fail to realize that we want to change a fact, a fact that continues to exist—for instance, the fact that a husband likes chess. Devoted to our fantasies, we avoid facing what is here.
A woman argued with her deadbeat husband who refused to look for a job. For years, she berated him for his behavior. She even relished a secret pride in “fighting the good fight” for her daughters. What did her fight achieve? She showed her daughters how to stay with a neglectful partner, wait for him to change, complain that he was not changing, and be proud of her choice to suffer: the heroism of masochism.
We ask people and life to change to be the way we want, and they do change. But they change their way, not ours. When they don’t change our way, our illusions can dissolve or we can hold on to them more fiercely. If our illusions dissolve, we feel pain.
While bearing the loss of our dreams, we need not be strong. We need only stand still without running while the true burns off the false.8 Hopes, thoughts, and ideas are so many moths burning up in the flame of life.
We hope to control what is, but we are like a wave trying to shove the river of life. The river is still here after the wave dies on the shore. We try to reject what is, but it cannot reject us. It always embraces us, try as we might to wriggle out. Can we accept reality’s embrace and return it?
Resistance = Suffering
When we embrace life, we cannot avoid pain. It is inevitable. We will lose everything we have and everyone we love before or at the moment of death.
In contrast, suffering is optional. Experiencing heartbreak, we may use defenses, the lies we tell ourselves to avoid the pain life brings. But our defenses—the ways we avoid reality—cause more suffering. We push away what is happening and the resulting feelings. “I’m not angry, just disappointed.” “I can’t believe it!” “She couldn’t have meant that.” Yet life keeps leaking through.
Remember the hallucinating woman whose husband left her? Facing his betrayal and the pain it caused was the easy part. Later in therapy we discovered that for years she had complained about the ways he treated her but then she waited for him to become someone else.
The hard part was facing how she had rejected him for years and blamed him for not being the way she wanted him to be. In fact, she had not been married to him but to the image she wanted him to become. Thus, she had divorced him years before without realizing it. Waiting for him to turn into someone else, she deprived and punished herself, calling it loyalty. She never realized that loyalty to the unreal was betrayal of herself.
At first, she thought he had been cruel to her. Eventually, she realized she had been cruel to him and to herself. Her task was to embrace the facts: he had left her, and she had left him, herself, and her feelings.
Taking responsibility for the life we created is hard when playing the victim is so easy: “They created my life!” The siren song of victimhood sounds so sweet, pure, and righteous as it lures us out of the river of life. We retreat into a netherworld where others are bad, we are good, and all is perfectly clear. Lost within our fantasies, we forget who we are: the space in which those illusions arise.
In the reassuring certainty of victimhood, we know what they did, why they did it, and what they should have done. All this “knowledge,” seemingly simple, true, and obvious, is merely our assumptions, factual only within the fantasy world dreaming between our ears. In fact, we never plumb the depths of another person completely. Since our understanding of others is always incomplete and partial, our “knowledge” is always a lie: a splinter masquerading as the tree.
And the “shoulds” are our directives to the universe. We tell people how they should be according to us, but the cosmos never notices; it goes its own way—not ours. Life keeps bumping into our shoulds: our fantasies of how we wish life would be.
When we expect what we want instead of life, we feel victimized by life, unaware of how we create our suffering. A depressed woman, furious with her husband, said he was insensitive, thoughtless, and cruel. I asked for an example. Through her tears she described how her husband had put his fist into her anus during lovemaking, causing excruciating pain. Horrified, I explored what happened and was shocked again: her husband asked permission to insert his fist into her anus during their lovemaking, and she gave her consent.
“He put his fist in my anus, and it hurt,” she said.
“He put his fist in your anus. Is that true?”
“Yes. I told you.”
“May I offer you a different perspective?” “Go ahead.”
“He asked you whether he could put his fist in your anus, right?”
“Yes.”
“You could have said no, but you said yes.”
“He didn’t want me to say no.”
“Right. You said no to yourself instead.”
“Oh.”
“You told him he could put his fist in your anus. In effect, you put his fist in your anus because you told him he could, but you blame him for your choice. You said no to yourself, and you blame him for that choice. Do you see what I mean?”
“I didn’t think of it.”
“If we think of it that way, what did you feel toward him when he asked to put his fist in your anus?”
“I didn’t like the idea.”
“But your feeling toward him?”
“I was angry.”
“You were angry with him. Then you dealt with your anger by turning it on yourself by inviting him to hurt you.”
“I forgot that I was angry with him.”
“Right. You felt angry with him, forgot your anger, and turned it on yourself by inviting him to hurt you. It was as if you invited him to punish you for being angry with him.”
“And later I invited him to criticize the food I made for dinner.”
“Yes. You invited him to punish you again for being angry. Is it possible that the person who is being cruel to you is you?”
She had been convinced he was cruel, he should be more sensitive, he should be more thoughtful. Yet by inviting him to hurt her, she had been cruel, insensitive, and thoughtless toward herself. In this victim stance, she asked him to love her when she refused to love herself. This strategy was doomed to fail because his love could never erase her self-hatred.
With the collapse of our imaginary victimhood, we see how we victimized ourselves, and the grief flows, revealing who we are.
Instead of giving up on our fantasies, however, we may mistakenly give up on life. A woman in an abusive relationship asked, “Am I supposed to give up on my husband?”
“No, but you may want to give up on your self-punishment.”
“Am I supposed to change?”
“It’s not a matter of whether you are supposed to change, but whether you want to.”
“Supposed to” is a hidden violence, an inner directive to do what we don’t want to do, feel what we don’t feel, and be who we are not. The best we can do in the moment may be to accept that we want to reject reality and cling to our illusions a little longer.
We can cling to illusions by asking our spouses to change into our favorite fantasies. A woman on her second marriage complained about her husband’s habits of watching television, buying DVDs, and spending time on charity work. She admitted that he was a good husband, but she kept trying to convince him that his hobbies were wrong. These arguments had escalated until her husband had threatened divorce, another deed he should not have done.
“How can I convince him that he is wrong to spend all his time watching football on the weekends?” she asked.
“Since he likes watching football, why shouldn’t he like what he likes?”
“Do you watch football?”
“No. Since he likes football, why shouldn’t he like watching it?”
“Because it’s a waste of time.”
“According to who?”
“Me.”
“Right. Since it’s a waste of time for you, you shouldn’t watch football. Since it’s a pleasure for him, he should.”
“But I can’t stand it!”
“Maybe he’s right. If you can’t stand him the way he is, you should let him go, so he can find a woman who can love him the way he is.”
“I give up!”
“That makes sense. Either you give up your wish for a man who wants what you want or you will have to give up your husband. You cannot avoid divorce. Either you divorce your fantasy of sameness or he’ll divorce you because I’m willing to bet another woman will love him in spite of his wish to watch football on Sunday.”
She wanted to control her husband to make him fit an image in her mind. But we never control reality, which never fits the images in our mind. When we swear off our fantasies, we unite with what is. Until then, the suffering caused by our resistance whispers to us: “You are lost in your fantasies; come home.”
Dancing on the Table
Rather than come home to a painful truth, we try to get rid of it. During a dinner years ago, an acquaintance of mine asked her husband, my wife, and me, “What would you ask for if you could have anything in the world?” We thought for a minute and answered. When her turn came, she said, “I have no need to dance on the table since I’ve been analyzed.”
I was puzzled by her comment at first until I realized what she meant. She wasn’t playing the game she had started. We revealed our desires; she didn’t. Then we learned a troubling truth. She believed psychoanalysis had purified her of neurosis, replacing her old personality. We had desires; she supposedly didn’t. I was angry that she had set us up and troubled by her yearning to be purified, thus boring.
She imagined that she needed to get rid of who she was to become who she wanted to be. A soul sister, she was showing me what I wanted from therapy too! Instead, we must let go of who we wish we were to be the presence we are.
Although therapists sometimes view psychotherapy as a modern “technology,” the word “psychology” originally meant the study of the soul. Why did her study of the soul turn into her contempt for it? She didn’t realize that to heal, we must embrace our inner messes, not eradicate them.
If a man confesses that he has been a petty thief, shall I condemn his conditioning or embrace it and the person underneath? Can I allow a shoplifter to touch and move me? Can I find wishes to steal within myself? What if he is showing me aspects of myself that I fear to face?
Healing occurs when we love our depths no matter how messy and pathological. Remember the joke: what is psychotherapy? It’s when a big mess meets a littler mess. Our raw vulnerability to life never goes away. Our task is not to eliminate but to embrace our humanity, often through embracing the humanity of others.
What do I doom within myself when I refuse your humanity? Your flaws are the mirrors in which I see myself. When I look into you, can I embrace your “defects,” meaning what I reject in myself? When I do, you and I discover one less dividing line between us. With every yes, we step closer toward embracing the other person’s depths, which are, in the end, our own.
Zero Negativity
At a conference a presenter described his goal for marriages: zero negativity—a relationship with no conflicts. I like science fiction too, but conflict is embedded in our lives. We have conflicting desires within ourselves and between each other. We always have different desires because I am not you, and you are not me. That’s not a problem, but how we are made.
I told a friend that zero negativity was a fantasy of returning to the womb. He corrected me. Even there we find negativity: the fetus ingests drugs her mother takes, and the mother is exhausted in the act of giving birth. We seek idyllic, nonexistent forms of closeness without conflict.
Do I wish everyone agreed with me? Yes. Does that happen? No. Is that negative? Not to my growth. If I step out of myself and let go of my other-image (my secret demands of others), I learn to accept people as they are. This is the first step toward love.
We long for a world where everyone gets along and the lion and lamb lie down together. What a beautiful story! When life shows up instead, we become angry. “My preference did not happen!” We want an imaginary world to avoid the real world. We yearn for spouses who want what we want, groups who cooperate, and colleagues who agree. “Don’t be who you are. Be who I want you to be.” We compare what happens with what we think should be happening and try to escape into our wishes.
Our demand for zero negativity reveals a negative mindset within ourselves. If I want no conflict, I don’t want you. Is there room for you and me? Is there room in me for the truth of you? If the universe has accepted positivity and negativity, why don’t we?
I go for a walk. I see the sun, the moon, and the stars. Looking down, I see dog feces on my shoe. In therapy we look inside ourselves and discover a landscape equally inclusive.
We are made messy, but we try to reject any part of reality that does not fit what we want. When we decide what we will accept and dismiss the rest, we sentence parts of ourselves to death row. We try to sanitize ourselves to appear like the purified pictures in our minds. This is not love, but hatred of life. When we try to transcend life, we reject it.
To aim for zero negativity, we must reject the negative in ourselves. A priest confided his self-hatred to me. I asked, “According to your theology, God made you in God’s image. Is that right?” He nodded. “And from your point of view, does God love you?” He nodded. “Since God made you in his image and loves you, wouldn’t it make sense to join Him by loving yourself?” His eyes filled with tears.
"Il Sorpasso" can be considered satire because it uses humor, irony, and exaggeration to criticize and mock certain aspects of Italian society. The film satirizes the characters' attitudes and behaviors, as well as broader social norms and values. For example, the character of Bruno, played by Vittorio Gassman, embodies a carefree and hedonistic lifestyle, constantly seeking pleasure and avoiding responsibility. His interactions with the more reserved and cautious character, Roberto, played by Jean-Louis Trintignant, highlight the contrast between their personalities and lifestyles, satirizing different attitudes towards life. The film also satirizes the idea of the "sorpasso" or overtaking, which becomes a metaphor for Bruno's approach to life, always trying to surpass others and live in the moment without thinking about the consequences. This is reflected in their road trip, where they constantly overtake other cars on the road, but also in Bruno's overall behavior and outlook on life. Overall, "Il Sorpasso" uses humor and wit to critique and satirize aspects of Italian society, making it a classic example of the commedia all'italiana genre.
An effleurage is a stroking movement, it is slow and rhythmical. Effleurage starts and concludes a massage routine as well as being used throughout to link other movements together. This movement introduces the therapists touch to the client.
Effleurage improves circulation, aids lymphatic circulation by removing waste products efficiently, promotes relaxation by soothing the sensory nerve endings, it allows client to become accustomed to the therapists touch, provides continuity of movement, aids desquamation.
Petrissage is a deeper pressure movement, types of petrissage movements include kneading, wringing, rolling and knuckling.
Petrissage improves circulation, increases lymphatic flow, improves absorption of substances within the tissues, loosens adherent tissues, removes tension, relieves aches and pains, removes lactic acid from muscle shape of the muscle being treated.
Tapotement are percussion movements, they are brisk and stimulating. Tapotement movements include hacking, clapping/cupping, beating and pounding.
Tapotement stimulates nerve endings, causes erythema, stimulates muscle fibres also known as toning, softens and loosens adipose tissue, increases cellular activity.
Frictions are deep pressure movements that are performed in a small circular motion over the underlying structures, they produce tension on the tissues and have a loosening effect.
Frictions increase localised circulation, breaks down adhesion in muscle, loosens scar tissue, increases joint mobility.
The advantages of using a massage oil are that it provides a good slip, it is inexpensive, and nourishing.
The disadvantages of using a massage oil are that it can leave a sticky residue on the skin, can stain linen, and some clients have nut allergies.
The advantages of using a massage balm or wax are that it is cleaner than oil to use, provides good slip, often have additives for specific effects e.g. warming, detoxifying.
The advantages of using a talc or corn starch powder for a massage is that it suits oily skin, suits hairy areas, enables deep precise movements.
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First, generate some concepts about what kind of game you want to create if it’s your first time. Second, research about the genre of the game you are trying to build, and create a game design document (GDD). Finally, figure out which programming language you are going to use, and make sure your game has all the facets you will need for your own game. You will also need quality assurance for errors. Anyone who is planning on developing their own game could benefit very much from this information to make sure their project is a success.
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-Metabolism :
Metabolism is the process by which your body converts what you eat and drink into energy
-Anabolic reactions : Construct things and consume energy.
-Catabolic reactions : break down molecules and release energy
-Nutrients :
the molecules that your body is forever breaking up and then rebuilding only to have them break apart again.
Water / Vitamins / Minerals / Carbohydrates / Lipids / Proteins
Part 2 Using Energy :
-Fats and carbs can be directly oxidized into usable energy
-Amino acids have to be converted into molecules that can be broken down like carbs to
get energy.
-Cellular respiration : Cellular respiration is a series of chemical reactions that break down glucose to produce ATP.
-Fed state Absorptive : During or after eating.
-Fasting state Postabsorptive : when the gi tract is empty and the body is running off stored supplies.
-Basal metabolic rate : is the number of calories you burn as your body performs basic (basal) life-sustaining function.
-Insulin : regulates blood glucose levels
-Lipoproteins : 4 specialized proteins made by the liver that surround fats and allow them to move in the bloodstream.
-Glucagon : increases blood sugar level by triggering the liver and adipose tissues to metabolize their fat and glycogen stores thereby releasing fatty acids, glycerol and glucose back in the blood
-Gluconeogenesis : body converts fats and amino acids into glucose.
Syndrome
A syndrome is a collection of recognizable traits or abnormalities that tend to occur together and are associated with a specific disease. A syndrome is really a collection of traits or distinctive features that run together.
A syndrome refers to a group of symptoms
Disease
A disease is a medical condition of the body which disrupts the normal functioning and physiological processes. Each disease has its own signs and symptoms attributed to it. It is generally accepted that there are four kinds of diseases – pathogenic, hereditary, physiological and deficiency.
The basic difference between the two terms relates to the symptoms that they produce. A disease can be defined as a health condition that has a clearly defined reason behind it. A syndrome (from the Greek word meaning ‘run together’) however, may produce a number of symptoms without an identifiable cause. A syndrome refers to a group of symptoms, while a disease refers to an established condition.
Symptom
A symptom is a manifestation of disease apparent to the patient himself, while a sign is a manifestation of disease that the physician perceives.
Disorder
A disruption of the disease to the normal or regular functions in the body or a part of the body.
For example, a disorder resulting from cardiovascular disease is an arrhythmia or irregular heartbeat. An arrhythmia is not a disease itself – it’s an abnormal heartbeat that occurs due to having cardiovascular disease.
Disorders can be classified into the following areas:
Mental
Physical
Genetic
Emotional
Behavioral
Structural
Condition
An abnormal state of health that interferes with the usual activities or feeling of wellbeing. Sometimes, a syndrome can be caused by a number of diseases or it can be a medical condition itself. For example, chronic fatigue syndrome is a neurological condition, diagnosed from a collection of symptoms in addition to the main symptom of post-exertional malaise.
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John Savil
Adam marczak / Free Practice
MS Learn
Adam’s path :
Module 1 : Cloud Concepts
Episode 1 : Cloud computing and vocabulary
Brain Basics: Understanding Sleep
Anatomy of Sleep
Sleep Stages
Sleep mechanisms
How Much Sleep Do You Need?
Dreaming
The Role of Genes and Neurotransmitters
Tracking Sleep Through Smart Technology
Tips for Getting a Good Night's Sleep
Hope Through Research
Where can I get more information?
Introduction
Sleep is an important part of your daily routine—you spend about one-third of your time doing it. Quality sleep – and getting enough of it at the right times -- is as essential to survival as food and water. Without sleep you can’t form or maintain the pathways in your brain that let you learn and create new memories, and it’s harder to concentrate and respond quickly.
Sleep is important to a number of brain functions, including how nerve cells (neurons) communicate with each other. In fact, your brain and body stay remarkably active while you sleep. Recent findings suggest that sleep plays a housekeeping role that removes toxins in your brain that build up while you are awake.
Everyone needs sleep, but its biological purpose remains a mystery. Sleep affects almost every type of tissue and system in the body – from the brain, heart, and lungs to metabolism, immune function, mood, and disease resistance. Research shows that a chronic lack of sleep, or getting poor quality sleep, increases the risk of disorders including high blood pressure, cardiovascular disease, diabetes, depression, and obesity.
Sleep is a complex and dynamic process that affects how you function in ways scientists are now beginning to understand. This booklet describes how your need for sleep is regulated and what happens in the brain during sleep.
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Anatomy of Sleep
Several structures within the brain are involved with sleep.
The hypothalamus, a peanut-sized structure deep inside the brain, contains groups of nerve cells that act as control centers affecting sleep and arousal. Within the hypothalamus is the suprachiasmatic nucleus (SCN) – clusters of thousands of cells that receive information about light exposure directly from the eyes and control your behavioral rhythm. Some people with damage to the SCN sleep erratically throughout the day because they are not able to match their circadian rhythms with the light-dark cycle. Most blind people maintain some ability to sense light and are able to modify their sleep/wake cycle.
The brain stem, at the base of the brain, communicates with the hypothalamus to control the transitions between wake and sleep. (The brain stem includes structures called the pons, medulla, and midbrain.) Sleep-promoting cells within the hypothalamus and the brain stem produce a brain chemical called GABA, which acts to reduce the activity of arousal centers in the hypothalamus and the brain stem. The brain stem (especially the pons and medulla) also plays a special role in REM sleep; it sends signals to relax muscles essential for body posture and limb movements, so that we don’t act out our dreams.
The thalamus acts as a relay for information from the senses to the cerebral cortex (the covering of the brain that interprets and processes information from short- to long-term memory). During most stages of sleep, the thalamus becomes quiet, letting you tune out the external world. But during REM sleep, the thalamus is active, sending the cortex images, sounds, and other sensations that fill our dreams.
The pineal gland, located within the brain’s two hemispheres, receives signals from the SCN and increases production of the hormone melatonin, which helps put you to sleep once the lights go down. People who have lost their sight and cannot coordinate their natural wake-sleep cycle using natural light can stabilize their sleep patterns by taking small amounts of melatonin at the same time each day. Scientists believe that peaks and valleys of melatonin over time are important for matching the body’s circadian rhythm to the external cycle of light and darkness.
The basal forebrain, near the front and bottom of the brain, also promotes sleep and wakefulness, while part of the midbrain acts as an arousal system. Release of adenosine (a chemical by-product of cellular energy consumption) from cells in the basal forebrain and probably other regions supports your sleep drive. Caffeine counteracts sleepiness by blocking the actions of adenosine.
The amygdala, an almond-shaped structure involved in processing emotions, becomes increasingly active during REM sleep.
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Sleep Stages
There are two basic types of sleep: rapid eye movement (REM) sleep and non-REM sleep (which has three different stages). Each is linked to specific brain waves and neuronal activity. You cycle through all stages of non-REM and REM sleep several times during a typical night, with increasingly longer, deeper REM periods occurring toward morning.
Stage 1 non-REM sleep is the changeover from wakefulness to sleep. During this short period (lasting several minutes) of relatively light sleep, your heartbeat, breathing, and eye movements slow, and your muscles relax with occasional twitches. Your brain waves begin to slow from their daytime wakefulness patterns.
Stage 2 non-REM sleep is a period of light sleep before you enter deeper sleep. Your heartbeat and breathing slow, and muscles relax even further. Your body temperature drops and eye movements stop. Brain wave activity slows but is marked by brief bursts of electrical activity. You spend more of your repeated sleep cycles in stage 2 sleep than in other sleep stages.
Stage 3 non-REM sleep is the period of deep sleep that you need to feel refreshed in the morning. It occurs in longer periods during the first half of the night. Your heartbeat and breathing slow to their lowest levels during sleep. Your muscles are relaxed and it may be difficult to awaken you. Brain waves become even slower.
REM sleep first occurs about 90 minutes after falling asleep. Your eyes move rapidly from side to side behind closed eyelids. Mixed frequency brain wave activity becomes closer to that seen in wakefulness. Your breathing becomes faster and irregular, and your heart rate and blood pressure increase to near waking levels. Most of your dreaming occurs during REM sleep, although some can also occur in non-REM sleep. Your arm and leg muscles become temporarily paralyzed, which prevents you from acting out your dreams. As you age, you sleep less of your time in REM sleep. Memory consolidation most likely requires both non-REM and REM sleep.
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Sleep mechanisms
Two internal biological mechanisms–circadian rhythm and homeostasis–work together to regulate when you are awake and sleep.
Circadian rhythms direct a wide variety of functions from daily fluctuations in wakefulness to body temperature, metabolism, and the release of hormones. They control your timing of sleep and cause you to be sleepy at night and your tendency to wake in the morning without an alarm. Your body’s biological clock, which is based on a roughly 24-hour day, controls most circadian rhythms. Circadian rhythms synchronize with environmental cues (light, temperature) about the actual time of day, but they continue even in the absence of cues.
Sleep-wake homeostasis keeps track of your need for sleep. The homeostatic sleep drive reminds the body to sleep after a certain time and regulates sleep intensity. This sleep drive gets stronger every hour you are awake and causes you to sleep longer and more deeply after a period of sleep deprivation.
Factors that influence your sleep-wake needs include medical conditions, medications, stress, sleep environment, and what you eat and drink. Perhaps the greatest influence is the exposure to light. Specialized cells in the retinas of your eyes process light and tell the brain whether it is day or night and can advance or delay our sleep-wake cycle. Exposure to light can make it difficult to fall asleep and return to sleep when awakened.
Night shift workers often have trouble falling asleep when they go to bed, and also have trouble staying awake at work because their natural circadian rhythm and sleep-wake cycle is disrupted. In the case of jet lag, circadian rhythms become out of sync with the time of day when people fly to a different time zone, creating a mismatch between their internal clock and the actual clock.
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How Much Sleep Do You Need?
Your need for sleep and your sleep patterns change as you age, but this varies significantly across individuals of the same age. There is no magic “number of sleep hours” that works for everybody of the same age. Babies initially sleep as much as 16 to 18 hours per day, which may boost growth and development (especially of the brain). School-age children and teens on average need about 9.5 hours of sleep per night. Most adults need 7-9 hours of sleep a night, but after age 60, nighttime sleep tends to be shorter, lighter, and interrupted by multiple awakenings. Elderly people are also more likely to take medications that interfere with sleep.
In general, people are getting less sleep than they need due to longer work hours and the availability of round-the-clock entertainment and other activities.
Many people feel they can "catch up" on missed sleep during the weekend but, depending on how sleep-deprived they are, sleeping longer on the weekends may not be adequate.
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Dreaming
Everyone dreams. You spend about 2 hours each night dreaming but may not remember most of your dreams. Its exact purpose isn’t known, but dreaming may help you process your emotions. Events from the day often invade your thoughts during sleep, and people suffering from stress or anxiety are more likely to have frightening dreams. Dreams can be experienced in all stages of sleep but usually are most vivid in REM sleep. Some people dream in color, while others only recall dreams in black and white.
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The Role of Genes and Neurotransmitters
Chemical signals to sleep
Clusters of sleep-promoting neurons in many parts of the brain become more active as we get ready for bed. Nerve-signaling chemicals called neurotransmitters can “switch off” or dampen the activity of cells that signal arousal or relaxation. GABA is associated with sleep, muscle relaxation, and sedation. Norepinephrine and orexin (also called hypocretin) keep some parts of the brain active while we are awake. Other neurotransmitters that shape sleep and wakefulness include acetylcholine, histamine, adrenaline, cortisol, and serotonin.
Genes and sleep
Genes may play a significant role in how much sleep we need. Scientists have identified several genes involved with sleep and sleep disorders, including genes that control the excitability of neurons, and "clock" genes such as Per, tim, and Cry that influence our circadian rhythms and the timing of sleep. Genome-wide association studies have identified sites on various chromosomes that increase our susceptibility to sleep disorders. Also, different genes have been identified with such sleep disorders as familial advanced sleep-phase disorder, narcolepsy, and restless legs syndrome. Some of the genes expressed in the cerebral cortex and other brain areas change their level of expression between sleep and wake. Several genetic models–including the worm, fruit fly, and zebrafish–are helping scientists to identify molecular mechanisms and genetic variants involved in normal sleep and sleep disorders. Additional research will provide better understand of inherited sleep patterns and risks of circadian and sleep disorders.
Sleep studies
Your health care provider may recommend a polysomnogram or other test to diagnose a sleep disorder. A polysomnogram typically involves spending the night at a sleep lab or sleep center. It records your breathing, oxygen levels, eye and limb movements, heart rate, and brain waves throughout the night. Your sleep is also video and audio recorded. The data can help a sleep specialist determine if you are reaching and proceeding properly through the various sleep stages. Results may be used to develop a treatment plan or determine if further tests are needed.
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Tracking Sleep Through Smart Technology
Millions of people are using smartphone apps, bedside monitors, and wearable items (including bracelets, smart watches, and headbands) to informally collect and analyze data about their sleep. Smart technology can record sounds and movement during sleep, journal hours slept, and monitor heart beat and respiration. Using a companion app, data from some devices can be synced to a smartphone or tablet, or uploaded to a PC. Other apps and devices make white noise, produce light that stimulates melatonin production, and use gentle vibrations to help us sleep and wake.
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Tips for Getting a Good Night's Sleep
Getting enough sleep is good for your health. Here are a few tips to improve your sleep:
Set a schedule – go to bed and wake up at the same time each day.
Exercise 20 to 30 minutes a day but no later than a few hours before going to bed.
Avoid caffeine and nicotine late in the day and alcoholic drinks before bed.
Relax before bed – try a warm bath, reading, or another relaxing routine.
Create a room for sleep – avoid bright lights and loud sounds, keep the room at a comfortable temperature, and don’t watch TV or have a computer in your bedroom.
Don’t lie in bed awake. If you can’t get to sleep, do something else, like reading or listening to music, until you feel tired.
See a doctor if you have a problem sleeping or if you feel unusually tired during the day. Most sleep disorders can be treated effectively.
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Hope Through Research
Scientists continue to learn about the function and regulation of sleep. A key focus of research is to understand the risks involved with being chronically sleep deprived and the relationship between sleep and disease. People who are chronically sleep deprived are more likely to be overweight, have strokes and cardiovascular disease, infections, and certain types of cancer than those who get enough sleep. Sleep disturbances are common among people with age-related neurological disorders such as Alzheimer’s disease and Parkinson’s disease. Many mysteries remain about the association between sleep and these health problems. Does the lack of sleep lead to certain disorders, or do certain diseases cause a lack of sleep? These, and many other questions about sleep, represent the frontier of sleep research.
Where Can I Get More Information?
For information on other neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute's Brain Resources and Information Network (BRAIN) at:
BRAIN
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424
www.ninds.nih.gov
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Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892
NIH Publication No. 17-3440c
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
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-La structure de la phrase
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-Le Sujet 15:05
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-Le Sujet et Le Verbe 20:44
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-le masculin et le féminin
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